Clinical Priority Setting and Decision-Making in Sweden: A Cross-sectional Survey Among Physicians.

Background: Priority setting in healthcare that aims to achieve a fair and efficient allocation of limited resources is a worldwide challenge. Sweden has developed a sophisticated approach. Still, there is a need for a more detailed insight on how measures permeate clinical life.

Early and long-term prognosis in patients with and without type 2 diabetes after carotid intervention: a Swedish nationwide propensity score matched cohort study.

Objectives: To investigate early and long-term outcomes after treatment of carotid artery stenosis in patients with type 2 diabetes (T2D) compared to patients without T2D.

Design/method: This observational nationwide population-based retrospective cohort study investigated all T2D patients treated for carotid stenosis registered in the National Swedish Vascular Surgery and the National Diabetes Registries. Data was collected prospectively for all patients after carotid intervention, during 2009-2015.

EVALUATION OF RADIATION DOSES USING CONE BEAM COMPUTED TOMOGRAPHY IN ENDOVASCULAR AORTIC REPAIR AND SCOLIOSIS PROCEDURES.

The aim of this project was to evaluate the radiation dose to patients for cone beam computed tomography (CBCT) in endovascular aortic repair (EVAR) and scoliosis procedures and to compare radiation doses between CBCT and computed tomography (CT). An anthropomorphic phantom and Siemens and General Electric X-ray equipment were used. Default protocol settings were used for comparison of protocols and modalities.

Topically applied mometasone furoate improves dysphagia in adult eosinophilic esophagitis - results from a double-blind, randomized, placebo-controlled trial.

Objectives: Topical corticosteroids are considered a cornerstone in the treatment of patients with eosinophilic esophagitis. The aim of this study was to evaluate the benefit of using mometasone furoate spray versus placebo on dysphagia and health-related quality of life in these patients.

Material And Methods: Consecutive, newly diagnosed adult patients with eosinophilic esophagitis were randomized and treated with either 200 micrograms of orally administered topical mometasone furoate or placebo 4 times daily for 8 weeks.

Effects of nutrition education using a food-based approach, carbohydrate counting or routine care in type 1 diabetes: 12 months prospective randomized trial.

Introduction: Evidence on the effects of structured nutrition education is weak in adults with type 1 diabetes mellitus (T1D) with moderately impaired glycemic control. Objective was to compare the effects of different types of nutrition education programs on glycemic control, cardiovascular risk factors, quality of life, diet quality and food choices in T1D.

Research Design And Methods: A 12 months randomized controlled study conducted at nine diabetes specialist centers with three parallel arms: (i) a food-based approach (FBA) including foods with low glycemic index or (ii) carbohydrate counting (CC) according to today's standard practice or (iii) individual sessions according to routine care (RC).

Clinicopathologic factors associated with malignant transformation of oral leukoplakias: a retrospective cohort study.

It is clinically challenging to identify oral leukoplakias that have a high risk of undergoing malignant transformation. The aim of this retrospective study was to elucidate the associations between malignant transformation of oral leukoplakias and various clinicopathologic factors. Patients with a diagnosis of clinical oral leukoplakia, verified through histopathologic examination and with access to digital images of the lesion, were retrospectively included for the period 2003-2013.

Patient related factors affecting in-hospital costs of a TURP procedure.

Treatment costs of lower urinary tract symptoms secondary to benign prostatic enlargement (BPE) are a substantial economic burden that will continue to increase in the future as a result of the ageing male population and increasing health awareness. The true costs for surgical interventions against BPE have been difficult to quantify as treatment costs strongly depend on the performance setting and may also vary among different healthcare systems, regions and institutions. The purpose of this study was to disclose the in-hospital costs and main expense items associated with a transurethral resection of the prostate (TURP).

AI-aided detection of malignant lesions in mammography screening - evaluation of a program in clinical practice.

Objectives: Evaluation of the degree of concordance between an artificial intelligence (AI) program and radiologists in assessing malignant lesions in screening mammograms.

Methods: The study population consisted of all consecutive cases of screening-detected histopathologically confirmed breast cancer in females who had undergone mammography at the NU Hospital Group (Region Västra Götaland, Sweden) in 2018 to 2019. Data were retrospectively collected from the AI program (lesion risk score in percent and overall malignancy risk score ranging from 1 to 10) and from medical records (independent assessments by two radiologists).

Integrating a pedagogic course in a CPD programme for paediatricians at out-patient clinics.

Equipping paediatricians for the challenges of the explosive development of knowledge and specialised health care calls for a well-planned continuing professional development (CPD) strategy which updates paediatric competencies and the pedagogic skills among paediatricians. The purpose of the study was to evaluate the effects of a pedagogic course, integrated into a CPD programme for paediatricians at out-patient clinics. The pedagogic course comprised three learning components, participation in a CPD programme, during two and a half years, a pedagogic learning module and a pedagogic assignment.

Combined Etanercept, GAD-alum and vitamin D treatment: an open pilot trial to preserve beta cell function in recent onset type 1 diabetes.

Aim: We aimed to study the feasibility and tolerability of a combination therapy consisting of glutamic acid decarboxylase (GAD-alum), Etanercept and vitamin D in children and adolescents with newly diagnosed with type 1 diabetes (T1D), and evaluate preservation of beta cell function.

Material And Methods: Etanercept Diamyd Combination Regimen is an open-labelled multi-centre study pilot trial which enrolled 20 GAD antibodies positive T1D patients (7 girls and 13 boys), aged (mean ±SD): 12.4 ± 2.

Characteristics of Continuous Glucose Monitoring Metrics in Persons with Type 1 and Type 2 Diabetes Treated with Multiple Daily Insulin Injections.

Although guidelines advocate similar continuous glucose monitoring (CGM) targets for insulin-treated persons with type 1 diabetes (T1D) and type 2 diabetes (T2D), it is unclear how these persons differ with respect to hypoglycemia, glucose variability, and other CGM metrics in clinical practice. We used data from 2 multicenter randomized-controlled trials (GOLD and MDI-Liraglutide) where 161 persons with T1D and 124 persons with T2D treated with multiple daily injections were included and monitored with masked CGM. Persons from both cohorts had similar mean glucose levels, 10.

Fournier's gangrene under SGLT-2 inhibitor therapy: A literature review and case report.

Introduction: Fournier's gangrene is a rare, life-threatening necrotizing infection of the perineum. In 2018, the U.S.

Antimicrobial coating is associated with significantly lower aerobic colony counts in high-touch areas in an orthopedic ward environment.

Background: Hospital acquired infections (HAI) are the most common complication found in the hospital environment. The aim of the study was to examine whether the use of an antimicrobial coating in high-touch areas in an orthopedic ward could reduce bacterial growth and HAI.

Methods: From December 2017 to February 2018, HAI were registered on two orthopedic wards.

Variables associated with insulin production in persons with type 2 diabetes treated with multiple daily insulin injections.

From the MDI-liraglutide study, we evaluated variables associated with endogenous insulin production in persons with multiple daily insulin injections-treated type 2 diabetes by relating C-peptide, proinsulin and proinsulin/C-peptide ratio at baseline to baseline variables. Lower insulin production was related to longer diabetes duration, shorter abdominal sagittal diameter and more glycaemic variability.

Mortality with Paclitaxel-Coated Devices in Peripheral Artery Disease.

Background: The results of a recent meta-analysis aroused concern about an increased risk of death associated with the use of paclitaxel-coated angioplasty balloons and stents in lower-limb endovascular interventions for symptomatic peripheral artery disease.

Methods: We conducted an unplanned interim analysis of data from a multicenter, randomized, open-label, registry-based clinical trial. At the time of the analysis, 2289 patients had been randomly assigned to treatment with drug-coated devices (the drug-coated-device group, 1149 patients) or treatment with uncoated devices (the uncoated-device group, 1140 patients).

Digitalization and Physician Learning: Individual Practice, Organizational Context, and Social Norm.

Introduction: The emerging context of online platforms and digitally engaged patients demands new competencies of health care professionals. Although information and communication technologies (ICTs) can strengthen continuous professional development (CPD) and learning at work, more research is needed on ICT for experiential and collegial learning.

Methods: The study builds on prior qualitative research to identify issues and comprises a quantitative assessment of ICT usage for learning in health care.

LDL cholesterol level as a risk factor for retinopathy and nephropathy in children and adults with type 1 diabetes mellitus: A nationwide cohort study.

Background: Microvascular complications are common in people with diabetes, where poor glycaemic control is the major contributor. The aim of this study was to explore the association between elevated LDL cholesterol levels and the risk of retinopathy or nephropathy in young individuals with type 1 diabetes.

Methods: This was a nationwide observational population-based cohort study, including all children and adults with a duration of type 1 diabetes of ≤ 10 years, identified in the Swedish National Diabetes Register between 1998 and 2017.

The road to diagnosis and treatment in girls and boys with ADHD - gender differences in the diagnostic process.

Introduction: The number of referrals for diagnostic assessments of Attention Deficit/Hyperactivity Disorder (ADHD) has increased in the last decade. There is a lack of studies examining the diagnostic process and the treatment provided, particularly from a gender perspective.

Methods: From a consecutive cohort of Child and Adolescent Psychiatric (CAP) outpatients, the medical records of 50 boys and 50 girls (under 18 years of age) with a diagnosis of ADHD were selected by an Excel random numbers generator.

A balance between meaningfulness and risk of harm - frail elderly patients' perceptions of physical activity and exercise - an interview study.

Background: There is growing evidence of the benefits of physical activity and exercise for frail elderly patients with comorbidity. In order to improve participation in physical activity and exercise interventions, there is a need to increase our understanding of the patient's perspective.

Aim: The aim of this study is to explore the perceptions of physical activity and exercise among frail elderly patients with a severe comorbidity burden.

The majority of people with type 1 diabetes and multiple daily insulin injections benefit from using continuous glucose monitoring: An analysis based on the GOLD randomized trial (GOLD-5).

Aim: To identify responders to continuous glucose monitoring (CGM) in relation to reductions in HbA1c and percentage of time spent in hypoglycaemia after initiation of CGM for individuals with type 1 diabetes treated with multiple daily insulin injections.

Materials And Methods: We analysed data from 142 participants in the GOLD randomized clinical trial. We evaluated how many lowered their HbA1c by more than 0.

Sustained Intensive Treatment and Long-term Effects on HbA Reduction (SILVER Study) by CGM in People With Type 1 Diabetes Treated With MDI.

Objective: Continuous glucose monitoring (CGM) reduces HbA and time spent in hypoglycemia in people with type 1 diabetes (T1D) treated with multiple daily insulin injections (MDI) when evaluated over shorter time periods. It is unclear to what extent CGM improves and helps to maintain glucose control, treatment satisfaction, diabetes distress, hypoglycemic concerns, and overall well-being over longer periods of time.

Research Design And Methods: The GOLD trial was a randomized crossover trial performed over 16 months of CGM treatment in people with T1D treated with MDI.

Dosage of oxytocin for augmentation of labor and women's childbirth experiences: A randomized controlled trial.

Introduction: The aim of this study was to compare childbirth experiences and experience of labor pain in primiparous women who had received high- vs low-dose oxytocin for augmentation of delayed labor.

Material And Methods: A multicenter, parallel, double-blind randomized controlled trial took place in six Swedish labor wards. Inclusion criteria were healthy primiparous women at term with uncomplicated singleton pregnancies, cephalic fetal presentation, spontaneous onset of labor, confirmed delayed labor progress and ruptured membranes.

Long-term efficacy and safety of dapagliflozin in patients with inadequately controlled type 1 diabetes: pooled 52-week outcomes from the DEPICT-1 and -2 studies.

Aim: To evaluate the efficacy and safety of adjunct dapagliflozin therapy in patients with type 1 diabetes (T1D).

Materials And Methods: DEPICT-1 and -2 were randomized, double-blind, parallel-group, 24-week studies, with 28-week extension periods. Adults with T1D and HbA1c 7.

Impact of CKD Progression on Cardiovascular Disease Risk in a Contemporary UK Cohort of Individuals With Diabetes.

Introduction: It remains unclear whether an increased progression rate of chronic kidney disease (CKD) adds predictive information regarding cardiovascular disease (CVD) risk. The aim of this study was to evaluate the association between CKD progression, based on estimated glomerular filtration rate (eGFR) slope estimates and the risk for CVD.

Methods: We compared the updated eGFR slope calculated over multiple overlapping 2-year periods and the updated mean eGFR.